Lower Measles and Mumps Seroprotection in Cancer Patients

Younger cancer patients with hematologic malignancies are less likely to have seroprotection against measles and mumps, according to a study presented at IDWeek, held virtually from October 21 to 25, 2020.

Recent outbreaks and declining vaccination rates of measles and mumps are a major concern for immunocompromised cancer patients, who are at higher risk for morbidity and mortality from vaccine-preventable diseases. This study measured measles and mumps seroprevalence among cancer patients at Seattle Cancer Care Alliance and compared seroprevalence based on demographic, disease, and treatment subgroups.

In total, 987 residual clinical plasma samples from patients were collected and tested for measles and mumps immunoglobulin (Ig)G using enzyme-linked immunoassary. Seroprevalence was calculated based on positive results, and equivocal results were not considered protective.

The median age of the patient population was 61 years (range, 2-97). Of the 987 cancer patients included, 574 patients (58%) had a solid tumor, 376 patients (38%) had a hematologic malignancy. Within the cohort, 155 patients (16%) were hematopoietic cell transplant (HCT) recipients, 46 patients (5%) received previous intravenous immunoglobulin, and 315 patients (32%) received chemotherapy in the past 30 days.

Results showed that 25% of cancer patients did not have evidence of seroprotection from measles and mumps; 75% (95% CI, 72-78%) of patients were seropositive for measles and 62% (95% CI, 59-65%) were seropositive for mumps. Seropositivity was the highest among those over the age of 63 who may have acquired immunity naturally. When compared to patients 80 years of age or older, patients aged 30 to 59 years were significantly less likely to be seropositive for measles and mumps (P <.002).

Patients with hematologic malignancies were less likely to be seropositive compared to patients with solid tumors (P <.001for measles; P =.003for mumps). Patients who underwent HCT at least 1 year ago were less likely to be seropositive for measles and mumps compared to patients who did not undergo HCT (P <.001); whereas patients who underwent HCT 1 year ago or earlier were less likely to be seropositive for mumps (P =.004) but not measles (P =.466). No significant differences in seropositivity were observed between men and women, patients who had received chemotherapy in the last 30 days, or between patients who had received prior intravenous IgG.

Overall, the study authors conclude that, “Deficits in protective antibody seen in this study are common among cancer patients and underscore the need for population/community-based efforts to increase herd immunity and protect vulnerable populations.”

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference:

Marquis S, Logue J, Loeffelholz T, et al. Gaps in measles and mumps seroprevalence among cancer patients. Presented at: IDWeek 2020; October 21-25, 2020. Poster 1076.